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Mar 2016 DOI 10.14302/issn.2471-7061.jcrc-15-899
K. Shin LewisCorresponding author
Department of Radiology, VA Palo Alto Health Care System, 3801 Miranda Ave. MC 114, Palo Alto, CA 94304
Missed cancers have been reported at higher frequencies in the right colon despite optical colonoscopy screening. The purpose of this study was to determine if there are regional differences in haustral fold height between the ascending, transverse, and descending colon using CT colonography (CTC). 50 supine CTC datasets from 50 asymptomatic, adult patients were analyzed (NCI-CBIIT instance of the National Biomedical Imaging Archive). At least 5 consecutive, pairs of unobscured haustral folds in each colonic segment were necessary to be included in this study. Of an initial 201 patients, 151 were excluded due to suboptimal colonic distension, retained fluid, tortuosity, and diverticulosis. For each dataset, the heights of the non-dependent haustral folds were measured in the ascending, transverse, and descending colon on 2D multiplanar reformations. Differences in mean HFHs were assessed using a hierarchical generalized linear mixed model. A total of 2079 colonic folds were measured: 625 in the ascending colon (including the cecum), 687 in the transverse colon, and 767 in the descending colon. The mean number of folds measured per segment was 6.87 ± 2.11. Mean HFHs were significantly taller in the ascending colon (14.62 ± 5.47 mm) than in the transverse (9.49 ± 3.65mm) or descending (6.53 ± 3.12mm) colon; mean HFHs were also significantly taller in the transverse than the descending colon, (P<0.0001, for all comparisons). In conclusion, taller colonic haustral folds are present in the proximal colon and may contribute to more frequently missed lesions (e.g. polyps) in the right colon by conventional, optical colonoscopy.
Dec 2025 DOI 10.14302/issn.3070-5835.jcpn-25-5939
Tamre SosinaCorresponding author
Objective To assess knowledge, attitude and willingness towards organ donation of nurses in Tibebe-Ghion Specialized Hospital, Bahir Dar, Ethiopia, 2023. Method A hospital based cross-sectional study was conducted from March 1 to May 30, 2023, using a census of all eligible nurses (N=215). Data were collected with a structured questionnaire adapted from validated tools. Binary logistics regression was used to identify factors associated with willingness to donate, with results presented as adjusted odds ratios with 95% confident intervals. Results The overall response rate of this study was 98% (n=206). The mean age was 29.5 (±4.8) years, and 55.8% were male. Overall, 61.7% (95% CI: 54.9-68.5) of nurses had good knowledge, and 45.6% (95% CI: 38.8-52.5) had a favorable attitude. In multivariable analysis, female sex (AOR=3.50, 95% CI: 1.18-3.92, p<0.001) and greater years of experience (AOR=2.15, 95% CI: 1.18-3.92, p=0.012) were independent predictors of willingness. Conclusion While a majority of nurses were willing to donate organs, significant gaps in knowledge and legal awareness persist. Female nurses and those with more experience were more willing to donate. Targeted educational interventions are recommended to address knowledge deficits and foster a more supportive environment for organ donation advocacy.
Nov 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5745
Poole JolyonCorresponding author
Background Healthcare worker stress, anxiety, burnout, and trauma have been widely documented across global healthcare systems. Staff in maternal and neonatal units frequently encounter emotionally distressing events and work under high pressure with limited resources. In Zambia, despite some gains in reducing maternal and neonatal mortality, fatality rates remain above national targets, exposing staff to repeated occupational trauma. Objective(s) This study aimed to assess the psychological well-being of staff in maternal and neonatal intensive care units, identify specific needs and stressors, and develop practical recommendations to improve resilience and support staff mental health. Methods A mixed-methods cross-sectional study was conducted at Ndola Teaching Hospital (NTH) and Arthur Davison Children's Hospital (ADCH), two major tertiary hospitals in Zambia. Data were collected over four days in February 2025. The study included 87 (out of 161) healthcare professionals, including nurses, midwives, and doctors. The Goldberg Anxiety and Depression Scale (GADS) and the Professional Quality of Life Scale Version 5 (ProQOL 5) were used to collect quantitative data, which were analysed using descriptive statistics and 95% confidence intervals (CI). Open-ended survey questions provided qualitative data, which were analysed using thematic analysis. Ethical approval was granted by the hospital ethics committee. Results High rates of clinical symptoms were observed. The overall prevalence of symptoms in the past 30 days was: anxiety (62%), depression (68%), burnout (50%), and secondary traumatic stress (46%). Junior doctors demonstrated the highest rates of depression (83%) and burnout (67%). The obstetrics and gynaecology and labour wards had the highest rates of secondary traumatic stress symptoms. Key qualitative themes identified were professional stressors, team and leadership issues, and the emotional burden of the work. Conclusion This study highlights an urgent need for both psychological and organizational support for maternal and neonatal healthcare staff in Zambia. The findings indicate that burnout and secondary traumatic stress are highly prevalent, particularly among junior doctors and those in high-risk wards. Targeted interventions at both systemic and individual levels are necessary to protect the well-being of healthcare workers and improve patient outcomes.
Dec 2024 DOI 10.14302/issn.2690-0904.ijoe-24-5353
Kissling KristinCorresponding author
Physical therapists (PTs) experience stress and burnout due to high job and productivity demands. Exercise can assist in decreasing stress and burnout, but finding the time to exercise can be difficult. This study examined the effects of a 28-day, 7-minute, high intensity interval training (HIIT) workout on PT’s stress and burnout levels. In this quasi-experimental pretest-posttest design, the Perceived Stress Scale, Maslach Burnout Inventory, grip strength, Functional Reach Test, and VO2max measures were administered on day 1 and day 28. Between the data collection period, participants completed a daily, 7-minute HIIT workout. A series of paired sample t-tests were computed to compare the pre- and post-HIIT raw values. Significant improvements were found in all comparisons post-HIIT (p< .001). Therefore, it was concluded that 7-minutes of HIIT can assist PTs in reducing stress and burnout levels. Employers should consider implementing a workplace wellness program to benefit their employees.
Aug 2024 DOI 10.14302/issn.2379-7835.ijn-24-5155
Bérgamo Silva LaraCorresponding author
Objective This report aimed to compare the total daily energy expenditure (TDEE) of adolescents measured by doubly labeled water (DLW) with the 2005 and 2023 dietary reference intake (DRI) equations proposed by the Institute of Medicine (IOM) in a sample of Brazilian adolescents. Methodology: This is a cross-sectional and observational study with a convenience sample of 15 obese and eutrophic adolescents, aged between 11 and 14 years, from public schools and the obesity outpatient clinic of the Clinics Hospital of the Ribeirão Preto Medical School – University of São Paulo (HC FMRP-USP) in Brazil. Were obtained stature and weight by conventional methods and used to calculate the body mass index (BMI) to determine the nutritional status. Fat-free mass (FFM) was measured using dual-energy X-ray absorptiometry. Energy expenditure was determined by DLW and estimated by the 2005 and 2023 DRI equations. The level of physical activity was measured with the ActivPAL™ accelerometer to classify adolescents within the equations. Results: Forty-seven percent of the sample were eutrophic and 53% were obese. The adolescents were classified as somewhat active according to the average number of daily steps. The DLW-derived TDEE and the TDEE derived from the 2005 and the 2023 predictive equations are presented as means, standard deviations, and 95% confidence intervals (CI). The 2005 and 2023 DRI equations produced significantly higher values than the DLW-determined TDEE (56.2% and 57.2%, respectively). Conclusion: Additional studies with Brazilian adolescents should be conducted to propose more accurate and specific predictive TDEE equations.
Jun 2024 DOI 10.14302/issn.2574-450X.jom-24-5114
Hammett FelixCorresponding author
Objective We aimed to assess outcomes in patients undergoing sequential intragastric balloon (IGB) treatment for obesity. Methods Consecutive patients who underwent treatment between May 2014 and February 2023 were identified. We recorded outcomes including: weight at 3-monthly intervals, progression to definitive bariatric procedure and morbidity. Results 45 patients were identified. Median weight loss with first IGB was 15.2kg (8.8%). 11 patients (26.7%) had a second IGB, with median weight loss of 3.3kg (1.9%). 21 patients (46.7%) were suitable for definitive surgery after first IGB treatment. One further patient (2.2%) was suitable for surgery after a second IGB. During first IGB, median weight loss was observed during the each of the first three quartiles (months 0-3: 10.1kg; months 3-6: 2.3kg; months 6-9: 4.2kg). There was a median 2kg weight gain during months 9-12. Conclusions Greatest weight loss was achieved during first IGB treatment. Sequential IGB treatment did not lead to beneficial weight loss or progression to surgery. Weight loss with first IGB was not uniform across the 12 month period of treatment, with net weight gain during the last quartile.
Mar 2024 DOI 10.14302/issn.2640-690X.jfm-24-5016
Murigi KevinCorresponding author
Background Antibiotics are the most prescribed medications worldwide. Global consumption rose by 65% in 76 low and middle-income countries between the years 2000 and 2015. According to the World Health Organization, improper administration of antibiotics occurs in over 60% of people with upper respiratory tract infections. Inadvertent antibiotic use has been identified as a contributor to antimicrobial resistance. Outpatient antibiotic use accounts for around 80-90% of all antibiotic use in patients. Clinical officers are non-physician healthcare workers who have received less training, have a more restricted scope of practice than physicians. Clinical officers are key service providers in this country especially at the primary healthcare level. Objective The study assessed the factors that influence antibiotic prescribing for upper respiratory tract infections by clinical officers. Method A prospective study was carried out at 20 public hospitals in Kiambu County, on 36 clinical officers and 600 patient prescriptions. The parameters measured were patient factors, prescriber factors, institutional factors and how they affected the antibiotic prescribing practices by either being rational or irrational. Rational prescribing was identified as prescribing the right drug, at the right frequency, in the right duration, right dose for the right indication. Prescriptions were considered irrational if they did not satisfy any of the rational indices. Data was collected via a questionnaire from the clinical officers while WHO prescription checklist was used to collect data from patient encounters. Data was analyzed using Statistical Package for Social Sciences version 22.0 (SPSS v22.0) with P-value, Confidence Interval and Odds Ratio. Results A total of 600 patient encounters were recorded and 79.8% of the 479 encounters had an antibiotic prescription for URTI, 91% of the antibiotics prescribed were the right dose, 98% had the right frequency, 75% had the right duration, and only 23% had the right indication. Patients above 65 years were more likely to receive an antibiotic prescription OR 3.98 CI 0.91,17.41 P=0.17 compared to children under 12 years old. Males were more likely to receive an antibiotic, but this was not significant OR 1.06 CI 0.70, 1.59 P=0.79. A total of 28 (4.6%) patients had fever, and all received antibiotics. A total of 36 clinical officers were sampled and only 5 (13.8%) were found to have rational prescriptions (P=0.63), prescriber age (P=0.92), prescriber level of education (P=0.99) and prescriber work experience (P=0.22) were not associated with antibiotic prescription. As per institutional factors, availability of antibiotics (P=0.026) and availability of prescription guidelines (P=0.012) were associated with rational prescription of antibiotics. Conclusion The study indicated that there was a high antibiotic prescription rate deviating from the WHO standard. It demonstrated that most antibiotic prescriptions were irrational.
Dec 2023 DOI 10.14302/issn.2381-862X.jwrh-23-4750
Godar MousamiCorresponding author
Background Preconception care is a crucial aspect of maternal and child healthcare services that aims to mitigate adverse pregnancy outcomes and enhance the desired health outcomes for women, newborns, and children. Despite the continuous multi-sectoral efforts in preconception care, maternal mortality and morbidity remain significant health concerns globally. This study aimed to assess the knowledge and practice of preconception care and its associated factors among women of reproductive age in Bheerkot Municipality, Nepal. Methodology A community-based descriptive cross-sectional study was conducted among 215 reproductive-age women to assess knowledge and practice regarding preconception care in Bheerkot Municipality, Nepal. Structured questionnaires were designed in the Nepali language and used in face-to-face interviews. We used a simple random sampling technique to collect quantitative data. In a statistical analysis, we employed the Chi-squared test and logistic regression analysis to identify possible predictors using the odds ratio and considered variables with p<0.05 statistically significant at a 95% confidence interval. Result Out of the 215 women who participated in the study, only 46.9% had a good knowledge of preconception care. Approximately half (43.7%) of the respondents had never practiced preconception care. Among respondents who had practiced preconception care before, 47.9% reported good practice, and 52.1% reported poor practice. Age of the respondent (χ2=14.2063, P=0.000823, df=1), marital status (χ2=17.9851, P=0.000022, df=1), time to reach a health facility (χ2=30.1371, P=0.00001, df=1), and age at first pregnancy (χ2=4.7975, P=0.0285, df=1) were statistically associated with knowledge about preconception care. Women who have foreign employment as a major source of family income and whose age is from 25 to 34 years were more likely to have a better practice of preconception care than their counterparts (COR 3.5000, CI 1.3343 to 9.1805, P = 0.0109) and (COR 3.4000, CI 1.1646 to 9.9265, P = 0.0252), respectively. Additionally, out of those who practiced preconception care, most respondents (93.4%) have practiced it in government health facilities. Conclusion Respondents had relatively poor knowledge and practice of preconception care. Collaboration of governmental health institutions between multiple sectors at local levels for more education and information and a specific national protocol or policy formulation would be beneficial in improving preconception care in Nepal.
Sep 2023 DOI 10.14302/issn.2381-862x.jwrh-23-4601
Ali Jemal SamrawitCorresponding author
Background The novel coronavirus COVID-19 has created massive challenges to public health worldwide. Pregnant women are an immune-depressed status which makes pregnant women generally more vulnerable to COVID-19 infection and severe illness. The present preventive measure practices have gaps. Therefore, the current study aimed to present accurate and latest information regarding preventive measures for COVID-19 infection among pregnant women. Methods and materials Institution-based cross-sectional study design was conducted on 422 pregnant women in public hospitals in Addis Ababa using a pretested structured questionnaire. Face-to-face interview on pretested and structured questions was conducted to collect the data between January 12 and February 15, 2022. The collected data were entered into Epi data version 4.4.2.2 and exported to SPSS window version 25 for analysis. Descriptive statics and multivariable logistic regression were analyzed. Odds ratio with a 95% confidence interval and p-value ≤ 0.05 were declared statistical significance independent variables. Result A total of 418 pregnant women participated, and the response rate was 99.05%. About 417 (99.8%) pregnant women reported never hearing about COVID-19. Of those who heard about COVID-19, only 49% and 54.3% had good knowledge and had good practice towards COVID-19 infection respectively. Age (26-30yrs (AOR=0.46, 95%CI: 0.014,0.12), no education (AOR=0.23, 95%CI: 0.099-0.52), Primary school (AOR=0.199, 95%CI: 0.104-0.4) and Secondary school (AOR=0.282, 95%CI: 0.14-0.55), divorced (AOR=0.15, 95%CI: 0.065-0.34) and widowed (AOR=0.16, 95%CI: 0.024-1.03)) were factors that associated with knowledge towards COVID-19 infection. Age (30-35yrs (AOR=0.334, 95%: 0.115-0.97) and >36yrs (AOR=0.28, 95%CI: 0.11-0.69)), no education (AOR=0.06, 95%CI: 0.019-0.18), being a civil servant (AOR= 0.28, 95%CI: 0.122-0.66), divorced (AOR=0.042, 95%CI: 0.01-0.18), having >4 family size (AOR=0.334, 95%CI: 0.169-0.66), no previous complication of pregnancy outcomes (AOR=0.019, 95%CI: 0.01-0.061), chronic health problem (AOR=14.66, 95%CI: 0.457-39.4) and two ANC visit (AOR=5.704, 95%CI: 2.41-13.5) were factors that associated with the practice towards COVID-19. Conclusion In this study area, only half of pregnant women had good knowledge and good practice about covid-19 infection prevention measures.
Jul 2023 DOI 10.14302/issn.2470-5020.jnrt-23-4576
HECHAM N.Corresponding author
Background The evolution of multiple sclerosis (MS) is highly variable. Predicting this evolution at the beginning of the disease will help in the therapeutic management. The objective of this study was to describe the clinical characteristics and to identify early predictors of long-term disability among MS patients in Algeria. Methods We performed a descriptive and retrospective study of 400 MS patients followed over a 4-years period from July 2012 to July 2016 in the neurology department of Mustapha Bacha hospital in Algiers. The following parameters were systematically assessed for each patient: Age at onset, gender, relapses, initial demyelinating event, interval between first and second attack, residual deficit after first attack, onset of the progressive course, time of assignment of the successive scores of irreversible disability and type of disease modifying therapies. Univariate and multivariate Cox models were used to determine factors influencing time to Expanded Disability Status Scale (EDSS) 4 and 6. Results During the follow-up of this cohort of MS patients, a total of 144 (36%) and 83 (20%) patients reached EDSS scores 4 and 6 respectively. The median times from the onset of MS to assignment of a score 4 and 6 was 10 years and 19 years, respectively. Using the MSSS severity score, and after univariate analysis we identified several risk factors predictive of disease severity. These included male sex (P= 0.002), age of onset ≥ 40 years (P= 0.001), pyramidal (P= 0.0001), cerebellar (P= 0.002), and poly-symptomatic (P=0.0001) onset of the disease, incomplete recovery after the first attack (P= 0.0001), a high number of attacks during the first 2 years (P= 0.04) and the progressive form (P=0.001), and all these factors were correlated with a high MSSS score. However, prognostic factors in the multivariate binomial logistic regression analysis were limited to pyramidal onset, incomplete recovery after the first attack, short interval between the first and second attack, and progressive onset. Conclusion On the whole, the early predictive factors of disability in MS among Algerian patients were age of onset over 40 years, pyramidal onset, incomplete recovery after the first attack, short interval between the first and second attack and progressive form at onset. To increase the generalizability of findings, a national MS registry is strongly recommended, as well as long-term follow-up epidemiological studies.
Apr 2023 DOI 10.14302/issn.2639-3166.jar-23-4500
A.Madam HarounCorresponding author
This investigation was carried out at the Demonstration Farm of the College of Agriculture- University of Bahri during 2018/2019 winter season to evaluate growth (morphological) and growth analysis (physiological) components in some sugar beet (Beta vulgaris L) genotypes under different nitrogen levels to know how well sugar beet plant performs during the growing season, Thus, to provide information to assist producers in identifying and introducing superior genotype and good management of nitrogen application in AlKadro area. The experiment was laid out in split plot design. The genotypes used were namely, Blaladi. Strube Sudan 01/14, Strube Sudan 02/14, Strube Sudan 04/14, Strube Sudan 05/14 and Strube Sudan 06/14, and the nitrogen levels were viz, 0, 80 and 120 kg urea per ha; applied twice (at the sowing and then 4 weeks after sowing). The evaluated components were; leaf number/plant, leaf area index (LAI), root length, root diameter, fresh and dry weight of foliage/plant, fresh and dry weight of root/plant; all determined at 5 terms. While Crop Growth Rates (CGR), Relative Growth Rate (RGR) and Net Assimilation Rate (NAR); determined at different periods of growth (intervals). The analysis of variance (ANOVA) revealed that at 4 weeks after sowing (WAS): leaf number (14.33- 17.03) , root length (19.05 – 21.75 cm), root diameter ( 7.93- 8.40 cm) foliage fresh ( 186.93 – 292.06 g) and dry ( 69.00 – 94.10 g) weight per plant, root fresh (72.66 – 108.88 g) and dry weight ( 12.54 – 22.08 g) per plant differed significantly (P≤ 0.05); at 7 and 10 WAS leaf number (22.39 -35.73 and 26.91 – 38.47, respectively), LAI ( 3.725 -5.645) , fresh and dry root weight per plant ( 586.78 – 913.81an 189.06 – 326.43 g, respectively) differed significantly; at 13 WAS: dry foliage weight ( 69.00 – 94.10 g), LAI ( 2.603 – 4.744), root diameter (10.09 – 11.92 cm) differed significantly; at 16 WAS only dry foliage (44.34 – 73.48 g) weight reflected significance. All other cases reflected insignificant differences among the evaluated genotypes. Moreover, all the studied components reflected insignificant differences among the nitrogen fertilizer levels and likewise genotype x nitrogen interaction (G x N) at the 5 sampled terms. Nevertheless, CGR, RGR and NAR displayed insignificant effect on the studied components in the evaluated periods.
Mar 2023 DOI 10.14302/issn.2994-6743.ijstd-22-4411
Tunta AbaynehCorresponding author
Background HIV causes immunosuppression, which reduces the body's immunity to diseases like COVID-19 by decreasing CD4 cells. The goal of this study is to determine whether persons living with HIV/AIDS (PLWHA) who are using anti-retroviral therapy (ART) are willing to accept the Coronavirus illness 2019 vaccination and the factors that influence their decision. Method From February 15 to March 15, 2022, 332 PLWHA on ART participated in this facility-based cross-sectional study. The correlation of outcome variables with predictors was investigated using binary and multivariable logistic regression. Result Of the 332 study participants, 110 (33.1 %) and 118 (35.5 %) had poor knowledge and a negative attitude toward the COVID-19 vaccination, respectively. Approximately 31 (9.3%) of study participants believe ART medications can also prevent COVID-19 infection. The willingness to receive the COVID-19 vaccine was 66.3 % with a 95 % confidence interval (60.9, 71.5). Knowledge, attitude, educational status, marital status, residency, duration, and monthly income were all significant predictors of willingness to receive COVID-19 vaccination. Conclusion Increased sensitization regarding the necessity of vaccines and the negative consequences of diseases, particularly among PLWHA, should be emphasized in the preparation of the COVID-19 immunization campaign involving prominent individuals such as health professionals and religious leaders.
Feb 2023 DOI 10.14302/issn.2379-7835.ijn-23-4430
A. Talal LillianCorresponding author
Background To determine the acute effects on postprandial lipemia and glycemia by supplementing a high-fat meal with either white button (WB) or shiitake (SH) mushroom powder. Methods Nine healthy participants (4-male, 5-female, 23.3±1.3 years, 17.8±6% body fat, 56.2±11.4kg fat free mass) consumed a control hamburger. At one-week intervals, after consumption of a control meal, participants consumed hamburgers in random order, supplemented with 14g of either WB or SH mushroom powder. Peripheral blood for lipids (triglycerides, high-density lipoprotein HDL, low-density lipoprotein LDL), and glucose was obtained at baseline (t=0 hours) and postprandially every two hours for six hours. Data were analyzed using linear mixed effects models. Results Lower LDL levels were observed for both SH and WB burgers compared to the control burger (p=0.0007) over the six-hour period. Mushroom powder content did not alter triglyceride, HDL, or glucose levels. Gender affected triglyceride and HDL levels over the treatment course. Triglyceride levels were higher in males (p=0.0084), and HDL levels were lower in females (p=0.0005). Triglyceride and glucose levels were higher, (p< 0.001 and p< 0.0001 respectively), during the postprandial time course (t=0, 2, 4, 6 hours). Conclusions Supplementing SH or WB mushrooms during a high-fat meal may lower serum LDL levels.
Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4325
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
The aim of this study is determine the prevalence and factors associated with caesarean section among women delivered at Kirehe District Hospital. A retrospective study was conducted among women delivered at Kirehe District Hospital from January 2018 to December 2019. The medical files of all women delivered at the hospital who meet the inclusion criteria were reviewed. Data were checked for completeness, cleaned, coded and entered into excel sheet, and then exported to SPSS version 22.0 for further analysis. Descriptive statistics was used to estimate the prevalence and description of study participants. Multivariable logistic regression models were used to estimate risk for CS with 95% confidence intervals (CIs). The study was conducted in accordance with the research protocol Mount Kenya University Rwanda research ethical committee. The majority 806 (69.9%) of women who delivered at Kirehe district hospital from January 2018 to December 2019 were aged 22-35 years old. The prevalence of C-section at Kirehe District Hospital was 23.1%. Demographic and economic factors associated with Caesaren section in bivariate and multivariate analysis was respondent’s type of health insurance where women who used private health insurance were 3 times more likely to deliver by C-section. The findings from multivariate analysis revealed that women who experienced eclampisa had 45% risk of C-Setion compared to those without Eclampsia. Women in rural area of Rwanda seem to have increased access to and use of CS. However, the significant increase in the rate of CS is of concern due to the potential of unnecessary CS.
Mar 2022 DOI 10.14302/issn.2641-4538.jphi-22-4113
L ProvvidentiCorresponding author
Postgraduate School of Public Health, Department of MESVA, University of L’Aquila (Italy).
Objectives Our study aims to determine the trend of the antibody titer and assess the efficacy of the vaccine. Methods It was conducted on 983 healthcare professionals between 27 February 2020 and 22 October 2021 at the Local Health Authority (ASL) of Rieti. Workers voluntarily underwent serological testing before vaccination (T1), at least 15 days after vaccination (T2), and at least 150 days after vaccination (T3). We picked individuals who had received two doses of the vaccine. As for positivity, we assessed incidence – and therefore symptomatology – in three time intervals. We used a contingency tables for the analysis and tested the relation to the chi-square test and ANOVA test. Regarding differentials in terms of antibody capacity, we considered different time intervals: the methodological approach was the same. Results The average value of the dimeric serological testing at T1 was equal to 28.80 AU/mL, which increased to 220.55 AU/mL at T2, and then decreased to 143.62 AU/mL at T3 (P = 0.000). At T2, the number of people with a protective titer was equal to 95.96% of the total; at T3, it was equal to 96.39% (P = 0.019). Before the vaccination campaign, 75 workers tested positive (25 paucisymptoms, 4 severe symptoms). After vaccination, 14 workers tested positive: almost all were asymptomatic. Conclusion Vaccination determines a statistically significant variation of the average value of antibody titer, a statistically significant reduction of positive swab tests and a better prognosis.
Nov 2021 DOI 10.14302/issn.2575-1212.jvhc-21-3973
A Elmetwally MohammedCorresponding author
Departments of Theriogenology,
This review focused on the various methods for controlling estrous cycles in well-managed dairy cows. Because up to 70% of dairy cows may stay non-pregnant after an AI procedure, an effective approach for identifying and reinseminating open cows is essential for dairy herds to achieve optimal reproductive performance. Overall, well-managed dairy farms with effective estrus detection programs inseminate 50% or more of non-pregnant cows after behavioral estrus is detected. Cows not detected in estrus are admitted in a resynchronization of ovulation procedure to receive a timed AI (TAI) service to avoid a long interbreeding interval. In Egypt, a widely used program involves starting the Ovsynch protocol (GnRH-7 d-PGF2-56 h-GnRH-16 to 20 h-TAI) 32 days after an initial AI, regardless of pregnancy status. Previous studies have proven that there was no difference in pregnancy/artificial insemination (P/AI) between Ovsynch+P4 and Presynch-Ovsynch, both protocols were equally effective in improving the fertility of cows with a CL 15 mm. The review also addressed different methods for synchronization of ovulation and different factors affecting the selection of the management program.
Oct 2021 DOI 10.14302/issn.2643-6655.jcap-21-3922
Ghazal ZandkarimiCorresponding author
Refah University, Tehran, Iran
This study aimed to evaluate acceptance and commitment therapy (ACT) effectiveness in reducing high-risk behaviors and elevating problem-solving strategies in adolescents with addiction susceptibility in cyberspace. This study is longitudinal with quantitative methods of data collection and analysis. The target community in this research was 60 female students randomly selected from a Persian high school in Iran. Participants were randomly divided and placed equally into the experimental and control groups. The participants’ entry criteria were gender, aged from 15 to 18 years, addiction susceptibility, and high-risk behaviors cut-off points. Eight training sessions of ACT were presented in cyberspace for the experimental group between the pre-test and post-test intervals. Data collection instruments were the Iranian youth risk-taking scale, problem-solving strategies, and Iranian adolescents’ addiction susceptibility questionnaires. Participants were followed up after two months. The results using multivariate analysis of among subjects ANOVA showed ACT significantly influenced high-risk behaviors and its’ sub-scales except for the violence (p < .001).Furthermore, ACT affected the problem-solving strategies and its’ sub-scales instead of control, creativity, and confidence (p < .001). According to the findings, ACT decreased high-risk behaviors such as drug abuse, smoking, and unprotected sexual behaviors. These changes might be due to decreased helplessness and avoidance as well as increased acceptance and tendency to solve problems. Instead, problem-solving strategies were improved through ACT cyber treatment.
Jul 2021 DOI 10.14302/issn.2835-2165.jfsh-20-3579
Bedada ShumiCorresponding author
Disease Control and Prevention Department, Bale Zone Health Office, Robe, Ethiopia.
Introduction Foodborne diseases are a major public health problem which predominantly affects infants and young children. Appropriate complementary food hygiene practice is very important to reduce the prevalence of foodborne illnesses. However, the information regarding this practice is not available and assessed before. Thus, the study was aimed to assess complementary food hygiene practices among mothers of children aged 6-23 months. Methods A community based cross-sectional study was conducted in Robe town on a samples of 517 mother-child pairs, which were selected by using systematic sampling technique. Data was collected using pre-tested and structured questionnaire, and each variable was described in the frequency and percentage. Bivariable and multivariable logistic regression analyses were used to identify factors associated with complementary food hygiene practice. Odds ratios with 95% confidence interval were used to assess levels of significance. Result The result indicated that 55% of participated mothers scored above the mean score of food hygiene practices. Mothers of children aged 12-23 months had higher odds to practice good food hygiene measures than those of aged 6-11 months (AOR, 1.82 95% CI (1.21, 2.73)). Mothers whose children attended growth monitoring session practice good food hygiene than their counterpart (AOR, 2.74 95% CI (1.49, 5.06)). Mothers having media exposure, and having knowledge on critical times of hand washing had relatively good food hygiene measures (AOR, 0.73 95 CI (1.14, 2.62)). Among food hygiene measures; handwashing with water and soap were low before eating food (17%), before feeding children (21%) and before preparing food (32%) when compared with after visiting the toilet (81%) and touching dirt (68%). Conclusion and Recommendation The study identified that food hygiene practices in the current study were mainly associated with child age, growth monitoring follow-up, maternal awareness about critical times of hand washing, and media exposure. So, improving knowledge of mothers on critical times of handwashing, strengthening growth monitoring follow-up and media promotion are important measures to improve food hygiene practices among mothers of infants and young children.
Sep 2020 DOI 10.14302/issn.2694-1201.jsn-20-3554
Getachew Kumara MitikuCorresponding author
Nekemte Referral Hospital, Oromia, Ethiopia.
Background Traumatic brain injury is an expanding major public health problem and the leading cause of death of the young and productive part of the world’s population. Research is mainly done in high-income countries where only a small proportion of the worldwide fatalities occur. Only few studies have examined prognostic factors of traumatic brain injury outcome in developing countries including Ethiopia. This study was aimed at defining the peculiar demographic and other associated factors of traumatic brain injury (TBI) outcome among patients treated for head injury at Nekemte Referral Hospital. Objective The main purpose of this study was to describe the magnitude of TBI outcome and assess factors associated with unfavourable outcome of TBI among patients treated for head injury at the surgical side in Nekemte Referral Hospital from July 8, 2016 to July 7, 2018. Methods A retrospective cross-sectional document review was conducted among TBI patients treated for head injury from July 8, 2016 to July 7, 2018 at Nekemte Referral Hospital. Data were collected using a pre-tested data collection format. Data analysis was done using SPSS version 20. Descriptive statistics were computed and association between the dependent and independent variables were assessed by using logistic regression. Odds ratios with 95% confidence interval were computed. Significant association was declared when the p value was <0.05. Results In this study, out of 378 cases 95 (25.1%) were discharged with unfavourable outcome of which 37(9.8%) were neurologic deficits and 58 were deaths giving overall mortality rate of 15.3%. Patient age>60years (AOR: 15.13; 95%CI: 3.575-64.028), time interval from injury to treatment (AOR: 16.054; 95%CI: 5.832-44.194), low GCS (AOR: 18.224; 95%CI: 4.167, 79.695), conservative management (AOR: 20.774; 95%CI: 6.106-70.681), pupils abnormality (AOR: 9.078; 95%CI: AOR: 2.996-27.509) were associated with unfavourable outcome. Conclusions A quarter of patients treated for TBI at Nekemte Referral Hospital are discharged with unfavourable outcomes. Old age, delayed presentation to the hospital, low GCS, conservative management, and pupillary abnormality increase the odds of unfavourable outcome. Timely management of TBI before patients develop secondary brain injury and use of surgical intervention based on CT scan diagnosis will reduce the occurrence of unfavourable outcome.
Mar 2020 DOI 10.14302/issn.2575-1212.jvhc-20-3234
di Virgilio FabrizioCorresponding author
DVM, Clinique Vétérinaire Vet24 – 59700 – Marcq en Baroeul, France
Aim of the Research The aim of this study is to analyze a group of dogs of different breeds affected by osteosarcoma (OSA), to document any prevalence of this primary bone neoplasia in breeds that are phylogenetically close and to help with further research human medicine, as a model of study for prevalence and epidemiology of human OSA in multiple populations. Study Design Pilot study from two canine surgery databases between 2002 and 2013. Materials and Methods Breeds were classified in groups based on their phylogenetical proximity. Differences in prevalence of OSA between breeds and groups were evaluated with a permutation test. For each breed and each group, a ranking was made by calculating 95 % confidence intervals and counting the no-overlapping between breeds and groups. The relation between the dogs’ heights and the prevalence of OSA was analyzed using a logistic regression between the disease status and dog size. Results A total of 67 dogs with OSA, in 26 different breeds were included. Ten breeds were overrepresented and, the majority of these, were classified in 2 predisposed groups phylogenetically close to each other. The prevalence of OSA was associated with the dogs’ height within predisposed breeds, but, in general, taller breeds were not the most affected. Conclusions and Clinical Relevance In this study, despite the small number of dogs, we observed that the most commonly affected breeds with OSA are phylogenetically closely related. This highlights the importance of genetics in the aetiology of canine OSA . In this preliminary study, indications are given on breeds, samples and genome locations to be further investigated. This could allow identification of pathogenic alleles in dogs, and potentially in humans. Furthermore this pilot research can represent a model of epidemiologic study of human OSA.
Feb 2020 DOI 10.14302/issn.2768-0207.jbr-20-3194
Mohammed AL-Namnam NisreenCorresponding author
Departmet of Oral Biology and Biomedical sciences, Faculty of Dentistry, MAHSA University, 42610 Bandar Saujana Putra, Malaysia
Rhinosinusitis is one of widely spread diseases in the region and the role of the anatomical variations in its pathogenesis remains unresolved. A retrospective study using CBCT scan was employed to locate and measure the diameter of 320 primary maxillary ostium (PMO) (n = 160 subjects) among the Malay and Chinese populations (Mongoloid race) in Malaysia. Image analysis was performed using the i-CAT Vision Software, employing the multiplanar reconstruction window in which axial, coronal and sagittal planes were visualized in 0.3 mm intervals. The mean diameter of the PMO was significantly larger in the Chinese than the Malay. Females had larger size than the male and bilateral asymmetry was noticed, where the right side PMO was larger than the left side (p < 0.05). In addition, PMO opened more in the posterior third position of the hiatus semilunaris (61.9%) than anterior and middle third. The PMO showed a statistically significant posteriorly placed position in the Chinese than the Malays and this was more evident in the right side PMO (p < 0.01). In conclusion, the PMO commonly opens in the posterior third of the hiatus semilunaris and its diameter is significantly greater in the Chinese female with evidence of bilateral asymmetry. Awareness the anatomical variation of the Ostium diameter and location among the Malay and Chinese populations potentially has important clinical effects during surgical procedures.
Oct 2019 DOI 10.14302/issn.2474-9273.jbtm-19-3027
Y Trivedi GunjanCorresponding author
Research Scholar, JJT University, Rajasthan, India and Co-founder, Society for Energy & Emotions, Wellness Space, Ahmedabad, Gujarat, India,
Introduction Sound vibrations have a profound impact on the body and the mind with evidence confirming reduced anxiety and increased wellbeing. The likely reason for driving the benefit is relaxation. The Himalayan Singing Bowls, used for therapeutic intervention to enhance the individual’s emotional & physical wellbeing, may facilitate faster and deeper relaxation as compared to simple, supine relaxation. Aim of the Study The study aimed to validate the hypothesis that short 20 minutes sessions to relax with the help of the Himalayan Singing Bowl (HSB) could provide better depth of relaxation as compared to Supine Silence (SS) based on the objective assessment of physiology parameters i.e. Stress Index & Heart Rate Variability (HRV). Methods Seven metal Himalayan singing bowls were used in a particular sequence learned from an expert teacher for 16 subjects. The SS group consisted of 17 subjects. The HRV data was measured by the Emwave Pro device and analyzed using Kubios HRV Premium software. The analysis compared key HRV parameters within and between the groups. Result Overall, as expected, both groups achieved relaxation as measured by changes in HRV parameters. However, further analysis confirmed a more consistent relaxation, as measured by a statistically significant reduction in stress index and an increase in HRV, for HSB group. The HSB group achieved more consistent depth of relaxation during each subsequent 5 minutes interval throughout the session as compared to SS group. Conclusion The study confirms that singing bowls sessions can be leveraged as a tool for inducing good quality relaxation response (increased parasympathetic tone, reduced stress) to facilitate healing and energy recovery in just 20 minutes and achieve significant health benefits. More comprehensive studies must be conducted to further evaluate the findings with more sample size, different methods of relaxation and varied demographics.
Jun 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2750
Konadu-Yeboah DominicCorresponding author
Orthopaedic and Trauma Surgeon, Komfo Anokye Teaching Hospital, Kumasi, Ghana, Part-Time Lecturer, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Purpose Foot injuries are common in low- and middle-income countries and continue to increase in incidence due to the surge in the use of motorcycles as means of transport.Yet, there is scanty data on the incidence and outcomes of treatment of open injuries to the foot in the developing world.We aimed to determine the incidence and functional outcomes of open foot injuries that are treated in a teaching hospital in Ghana. Methods We used a structured questionnaire to record the type of open foot injury, the mechanism of injury, any concomitant injuries, the time interval between injury and arrival at the hospital for treatment as well as the type of treatment instituted. Recruited patients were followed up for six months, complications resulting from the injury or its treatment were recorded for each patient. The function of the foot after healing of the injury was measured using a questionnaire-based visual analogue outcome scale of the American Foot and Ankle Society. Regression and chi-square analysis were used to evaluate potential associations. Results Over a four-month period, a total of 81 cases of open injuries to the foot were recorded. Out of this figure, 55 patients (67.9%) were males and 26 (32.1%) were females. It was found, that 66.7% aged between 19 and 49 years, 76.5% of the injuries occurred on the road and 29.7% was motor cycle related. Pedestrians are the most afflicted (61.7%). The treatment outcomes of traumatic amputations, open phalangeal fractures, dorsal skin degloving and lacerations were good. Gustillo-Anderson grade IIIB open fractures with associated plantar skin degloving had the worst outcomes with residual pain on weight bearing, bigger foot, inability to wear previous shoes and inability to tiptoe on the affected foot. Conclusions Open injuries to the foot are common in Ghana and exert a significant health burden, particularly on active young males. Long term disability may occur, even after adequate treatment of open fractures involving the foot.
Apr 2019 DOI 10.14302/issn.2470-0436.jos-19-2693
E. Moroi SayokoCorresponding author
Department of Ophthalmology and Visual Sciences, University of Michigan, 1000 Wall Street, Ann Arbor, Michigan, 48105 USA.
Given limited knowledge regarding validity of the Titmus vision screener, we sought to compare visual acuity measurements obtained from the Titmus with that from the Snellen chart and assess the validity properties of the Titmus as a screening instrument to detect vision impairment. Visual acuity was measured in 150 participants recruited from an academic ophthalmology practice, using the Snellen chart as well as the Titmus vision screener. Visual acuities from the Titmus and Snellen were compared and validity of the Titmus vision screener was assessed by computing sensitivity and specificity. Using Snellen visual acuity as the reference standard, the sensitivity of the Titmus vision screener to detect vision impairment, defined as visual acuity worse than 20/40, was 92% (95% CI (72.5, 98.6)) and the specificity was 64% (95% CI (57.9, 70.1)). Comparisons of the precise visual acuity level revealed poor agreement between the two methods (weighted Kappa: 0.15, 95% CI (0.08, 0.21)). Visual acuities obtained from the Titmus were, on average, two lines worse than Snellen visual acuities. ((logMAR Snellen – logMAR Titmus) = - 0.19 ± 0.29, 95% confidence interval (CI) (-0.23, -0.16)). Titmus vision screener is a sensitive tool to detect visual impairment. However high false positive results and poor agreement with Snellen limits its widespread use in clinical applications.
Mar 2019 DOI 10.14302/issn.2639-3166.jar-19-2691
Masoero GiorgioCorresponding author
Accademia di Agricoltura di Torino, Italy
In precision agriculture (PA) fertilizing, based on soil testing, production maps and crop nitrogen (N) demand, is the key to maximizing yields and tempering fertilizer costs. A trend study has considered the output / input relationships performed on a farm that has progressively adapted to PA procedures over two decades. The evolutions of the variability parameters of yield, comprising the repeatability coefficient of repeated plots, the vegetative vigour (NDRE) at the panicle initiation (pi) stage, and the nitrogen utilization efficiency (NUE) were monitored and compared by means of mixed linear models over a six-year period, after the variable nitrogen (N) fertilization rate (VNFR) had been enlarged to the whole 230 ha of one farm. At pi key fertilization stage, a corrective dose was applied by tacking the correlation between Npi and the measured NDRE in strong negative mode. The evolution of the yield, for the 2012-2017 interval, based on 1165 ha-1 parcel-data, showed a significant yearly increase of 2.3% more than the regional trend (+0.5%). The variability parameters of the yield, that is, the standard deviation (+7.3%), range (+7.1%), coefficient of variation (+5.4%) and maximum (+2.1%) were enhanced over the years, but the minimum remained stable. The repeatability of the parcel yield generally appeared low (r = +0.31), but it tended to increase by 8.3% year-1 (P = 0.018). At the same time, the vegetational vigour also showed significant increases of the NDRE means (+3.0%) as well as of the maximum (+0.8%), but also large oscillations in the standard deviation and in the coefficient of variation. No significant regression of the NDRE on the coefficient of variation of the yield was established. The favorable increase in yield was found to be independent of the distributed N-total. A strong negative correlation (imposed) between N-pi and NDRE (-0.90) and a negative correlation with production were observed for a sample field (but in the area of maximum production). It is recommended that a partial correlation between Yield and N-tot should be considered in the I /O features for a parity of NDRE, which apparently decreases the negativity of the relationship. In short: with the same total input of N, the PA increased the yield, but also its variability – and it did not reduce the variability as predicted by the theory - by strengthening the repeatability. This is an evidence that in many of the parcels with minimum yield the limiting factors cannot be referred to the N availability.
Mar 2019 DOI 10.14302/issn.2690-4721.ijcm-19-2616
Srinath Kamineni,Corresponding author
Department of Orthopaedics and Sports Medicine, Elbow Shoulder Research Center, University of Kentucky, Lexington, KY 40536
Introduction Ultrasound technology has previously been applied for cataract removal and tennis elbow treatment. Recent data supports the use of ultrasonic debridement in the treatment of diabetic foot ulcers. No data is available concerning the potential antibacterial properties of a clinical grade, lower energy ultrasound probe. We investigated the effect of a ultrasonic probe with respect to P gingivalis bacterial viability. Methods A Tenex Tx1 probe with standard settings for clinical use was used for this study. A Gram negative (Porphyromonasgingivalis) bacteria, known for its pathological activity, was investigated. The bacteria was cultured in an anaerobic broth, re-suspended to achieve a consistent bacterial count, and 5ml of this re-suspension was placed in a test tube for testing. Each tube was sonicated with the Tx1 probe for varying lengths of time (10, 30, 60, 120 seconds). The sonicated was diluted and plated on blood-agar plates, followed by incubation for 48 hours at 37°C in an anaerobic growth chamber. The number of colony forming units were counted, on each plate and the anti-bacterial effect was calculated. A one way analysis of variance was performed for statistical analysis. Results A significant time-dependent antibacterial effect was demonstrated with sonication. When comparing the kill rate between the control and 120 seconds of sonication P Gingivalis had a 64% kill rate. This was the only statistically significant time comparison achieved, although the trend for all the time intervals was a reduction in the colony forming unit counts. Conclusion This study demonstrates that a clinically available ultrasonic probe (Tenex Tx1) has an antibacterial effect against the gram negative anaerobic bacterial species P gingivalis. Complete deactivation was not achieved, and there was a variation in effect dependent on the time of active sonication, with greater sonication times leading to greater kill rates. This data may partially help to explain the ability for ultrasonic debridement to result in the healing of long standing diabetic ulcers, that have been recalcitrant to other forms of treatment.
Jan 2019 DOI 10.14302/issn.2470-0436.jos-19-2602
Adaboh HayfordCorresponding author
Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Vision impairment and blindness remain a challenge in developing countries, especially in rural communities. Notwithstanding, VISION 2020 global initiative seeks to eliminate avoidable blindness by 2020. This community-based cross-sectional study aimed at determining the accessibility of ophthalmic services and barriers to its utilization in rural communities in the Upper Denkyira West District, Ghana. One-hundred and seventy participants from 5 randomly chosen rural communities in the district were included. Participants were interviewed using a structured questionnaire. Socio-demographic information, information regarding accessibility, utilization, and barriers to eye care services were obtained. Descriptive statistics were carried out using SPSS version 23. The Chi-squared test was employed to determine associations. P-values less than 0.05 at a confidence interval of 95% were considered significant. Only 21.8% of participants had had eye examination within the past 3 years, with over half of the examinations undertaken at screening grounds and health centres. Significant associations were found between ophthalmic services utilization and increasing age (p = 0.004), female gender (p = 0.027) and those who had a past history of eye problem(s) (p = 0.0010. The study found gross inadequate utilization of ophthalmic services mainly due to unavailable ophthalmic services in the rural district. Public health education and eye care interventions should prioritize and target rural populations. Key Messages This study found gross inadequate utilization of ophthalmic services mainly due to unavailable ophthalmic services in the rural district. Rural dwellers were thus compelled to resort to harmful eye care practices. Public health education and eye care interventions should prioritize and target rural populations
Jan 2019 DOI 10.14302/issn.2574-4496.jtc-18-2473
Noguchi YasushiCorresponding author
Department of Radiology, Noguchi Thyroid Clinic and Hospital Foundation, 7-52 Aoyama-cho, Beppu 874-0902, Japan
This study aimed to investigate the trend of patients with thyroid cancer undergoing thyroidectomy and those undergoing fine needle aspiration (FNA) and its relationship with thyroid cancer, using a large-scale, real-world database established based on the employment-based health insurance claims data in Japan. In this retrospective descriptive study, annual incidence rates of patients with thyroid cancer undergoing thyroidectomy and FNA from 2005 to 2014 were calculated. Among the 3,130,757 enrollees, 926 patients were diagnosed with thyroid cancer and underwent thyroidectomies. The annual incidence of patients with thyroid cancer undergoing thyroidectomy increased from 5.4 (95% confidence interval 95% CI, 3.4–8.5) in 2005 to 11.7 (10.1–13.5) per 100,000 patient-years in 2013, with a gradual increase among patients in their 20s and 30s and with the most notable increase among those in their 40s and 50s. The annual FNA rate also increased during those years, whereas no noticeable change was observed in the thyroid cancer detection rate. The incidence rates of patients with thyroid cancer undergoing thyroidectomy and those undergoing FNA were strongly correlated, with Pearson’s correlation coefficients of 0.935 for men and 0.886 for women. In conclusion, an increasing trend in the incidence of patients with thyroid cancer undergoing thyroidectomy was observed from 2005 to 2013 among a large group of Japanese employees of working age and their dependents. These results provide useful information on the impact of patients with thyroid cancer undergoing thyroidectomy on the working population.
Oct 2018 DOI 10.14302/issn.2637-6075.jpae-18-2349
Chibueze Izah SylvesterCorresponding author
Department of Biological Sciences, Faculty of Science, Niger Delta University, Wilberforce Island,Bayelsa State, Nigeria.
Nigeria is the world leading producer of cassava. During processing of gari from cassava tuber large volume of effluents are discharged in the environment which is toxic to the environment and some of its associated biota. This study evaluated the growth pattern of Saccharomyces cerevisiae in cassava mill effluents. The Saccharomyces cerevisiae was isolated from palm wine following standard microbiological procedure. The Saccharomyces cerevisiae was inoculated into the sterile effluents and incubated for 15 days. At every 3days interval, 1ml of the effluents was obtained from the medium and the population density determined. Results of the growth showed that the population of Saccharomyces cerevisiae were 0.00 x 106 cfu/ml at day 0 (without inoculum), which rose to 2.88 x 106 cfu/ml at day 3, 272.67 x 106 cfu/ml at day 12 and decline slightly at day 15 (13.57 x 106 cfu/ml). There was significant variations (P<0.05) among the various period of study. The study showed that the growth of Saccharomyces cerevisiae in the effluent was optimum at day 12, then after the density began to decline.
Jul 2018 DOI 10.14302/issn.2690-4837.ijip-18-2238
MugishaTaremwa IvanCorresponding author
Clarke International University, Kampala, Uganda
Background Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is recognized as an association towards development of infections that may cause of morbidity among people living with Human Immunodeficiency Virus (PLWHIV). We report on the prevalence, antibiotic susceptibility pattern and risk factors associated with MRSA carriage among PLWHIV at Nyenga hospital, Buikwe district in central Uganda. Materials and Methods We conducted a cross-sectional study among PLWHIV attending Nyenga hospital anti-retroviral therapy (ART) clinic. Nasopharyngeal swab was collected from each participant, cultured to isolate Staphylococcus aureus, and drug susceptibility testing (DST) performed. Sociodemographic data and medical history was recorded. Results We enrolled 219 PLWHIV; of these, 58.4% (N=128) were females. The majority of participants (95.0%) were on ART. Ninety-eight (44.75%) of the nasopharyngeal swabs had growth, of which 41 (41.84%) were S. aureus. Of these, 11 (5.02%, 95% confidence interval: 3.67-7.02) were MRSA. Of 41 isolated S. aureus strains, only 8 (19.51%) were susceptible to all antibiotics tested. A total of three (7.32%) were multi-drug resistant (MDR), while one1 (2.43%) was a possible extensively drug resistant (XDR) strain. Deteriorating immunologic state as indicated by a low CD4 count showed a significant association with the MRSA colonization. Conclusion These results are reassuring that MRSA colonization is high among PLWHIV. As most of the antibiotics in use were resistant, it raises concerns of intricate clinical management in a low resource set up.
Jun 2018
Depres JanCorresponding author
Department of Obstetrics and Gynecology, Division Woman and Child, University Hospital Gasthuisberg.
Our study aims to help researchers calculate resources based on a rat breeding colony for experiments on fetal lung development. The Wistar rat is commonly used in experimental research. In the context of fetal lung studies, the nitrofen rat is a model for pulmonary hypoplasia and congenital diaphragmatic hernia. Data needed to calculate resources for new experiments are not easily available. We prospectively acquired data on the reproductive performance and fetal outcome of 314 consecutive virgin Wistar dams in our fetal lung research breeding colony. We define the impact of breeding conditions on rat fertility and evaluate different methods to diagnose early rat gestation. Effects of nitrofen exposure as well as fetal surgery in terms of prenatal mortality and gross anatomical parameters of lung development are quantified in nitrofen-exposed and -unexposed fetuses from embryonic day 19 to 21 in 12h intervals. A reduced mating interval (1h) provides a great degree of experimental control with feasible pregnancy rates and a large litter size. Nitrofen exposure, as well as fetal surgery, depict high fetal survival rates. Fetal lung findings were very reproducible and could allow for reduction of animals utilized within experimental groups.
Feb 2018 DOI 10.14302/issn.2329-9487.jhc-18-1932
Erne PaulCorresponding author
Faculty of Biomedical Sciences, Universita della Svizzera Italiana, Lugano, Switzerland
The aim of this study was to assess the use of ambulatory acoustic cardiography during the initial data collection of the longitudinal study of a rural population in Switzerland (n=297, mean age 48.9 ±16.5 years, 57% female). Ambulatory acoustic cardiography non-invasively can assess sleep disordered breathing (SDB) and provides markers of left ventricular systolic and diastolic dysfunction. The percentage of the third heart sound detected during sleep decreased significantly across age groups (age < 40 years, 40-60 years, > 60 years) for both genders (males, p=0.04; females, p=0.02). The percentage of a fourth heart sound detected exhibited an increasing trend for both genders with age suggesting increased diastolic dysfunction with aging. Mean electromechanical activation time (EMAT) during sleep was within the normal range across age groups and both genders (male 93.7 ± 11.6 ms, female 94.6 ± 13.0 ms), and did not vary significantly with age. A large proportion of subjects had a high likelihood of sleep disordered breathing (17.6%). Baseline characteristics categorized by SDB severity indicate increasing age, male gender and being overweight (BMI ≥ 25) to be associated with greater SDB severity. Acoustic cardiography findings categorized by SDB severity reveal increased nocturnal non-dipping heart rate, presence of atrial fibrillation, prolonged QRS duration and QTc interval, increased percentage of fourth heart sound detected, and longer EMAT to be significantly associated with greater SDB severity. Overall, acoustic cardiography detected a very low prevalence of systolic dysfunction, age-related increases in diastolic dysfunction and a moderate prevalence of sleep disordered breathing.
Aug 2017 DOI 10.14302/issn.2471-7061.jcrc-17-1624
Claudia PieperCorresponding author
Institute for Medical Informatics, Biometry und Epidemiology, University Hospital of Essen, Hufelandstraße 55, 45122 Essen, Germany,
Background Despite the existence of the statutory early cancer detection program in Germany and the removal of financial barriers, which is frequently reported in the literature to be the main obstacle in screening, uptake of colorectal cancer screening remains quite low. The campaign for colorectal cancer screening in German companies reported in this article started in 2010. It was initiated because of the low compliance with opportunistic public colorectal cancer screening efforts. Its goal is to improve participation by offering an organized screening program using a simple test (FIT). Methods An offer for company employees is publicized through posters, company newsletters and the intranet. The difference between the positivity rates of those who returned the kits within 20 days and later than 20 days was assessed using the Z-test. The average time between a positive result and colonoscopy was estimated using the Poincaré plot method. The positive predictive values were calculated for carcinomas, advanced adenomas or any lesions. The sensitivity and specificity of immoCare-C published by Vogel et al. and Hundt et al. were used to derive the confidence intervals for the positive likelihood ratio (for carcinoma and any kind of adenoma). Results A total of 312,147 kits were returned and analyzed (return rate 70.2%). 5.6% gave a positive result. The PPV for cancer aged between 55 and 74 was 4.6% for men and women (95% CI: 2.38%-6.76% and 1.28%-7.99%, respectively), but 22% for men (95% CI: 17.93%-26.65%) and 8% for women (95%CI: 3.63%-12.26%) for advanced adenomas. The PPV for any lesion was higher for those with familial risk (49.3%) and 42.6% for those without familial risk (95% CI: 40.2%-45.0%), but with overlapping confidence intervals. Conclusions The reported sample is not representative. Although, offering CRC screening in companies may be an effective way of increasing uptake in the target population. Differences in the test performance between men and women need further evaluation.
Aug 2017
Nevzat UzunerCorresponding author
Objectives Increased neurovascular (NV) reactivity has been shown in patients with relapsing-remitting multiple sclerosis (RRMS) during the acute exacerbation period. However, the NV reactivity after several attacks is not known. We, therefore, have investigated the patients by transcranial Doppler (TCD) using simple visual stimulation after the repeated attack periods. Patients and Methods Thirty patients (22 females and eight males, mean age 40 years) with RRMS were examined at least two times. The average TCD examination interval was 26.7 months (range 4-120 months). Mean attack number was 3.8 (range 2-8 times), average disease duration was 57 months (range 4-124 months), and average Expanded Disability Status Scale (EDSS) value was 2.5 (range 1-5.5). We performed transcranial Doppler recordings from the P2-segments of both posterior cerebral arteries simultaneously during simple visual stimulation. The NV reactivity was defined as a relative increase of the blood flow velocities during visual stimulation. Results The NV reactivity to simple visual stimulation was significantly lower in the second test on both sides (31.5±9.2% and 29.2±7.2%; right and left side, respectively) from those of the first test (38.3±11.9% and 36.0±11.9%; right and left side, respectively) (p<0.001). Conclusion The present study is the first study examining neurovascular reactivity in patients with RRMS during repeated attacks using the transcranial Doppler to our best knowledge. Our results suggest patients with RRMS after repeated exacerbation periods have less reactive neurovascular units in the occipital cortex. The possible explanation might be the repeated demyelination, and insufficient remyelination with longer disease duration may lead glial dysfunction resulting neurovascular unit impairment. If so, functional TCD may be useful for the determining of the disease progression. However, the exact cut-off point is not known.
Jan 2017 DOI 10.14302/issn.2476-1710.jdt-16-1324
Meiser SusanneCorresponding author
University of Potsdam, Department of Psychology
An important step in the validation of disorder-specific etiological models is the examination of the predictive specificity of proposed vulnerability factors. It may advance the understanding of the emergence of comorbidity and the identification of at risk-populations for mental disorders. To enhance the currently limited evidence on the specificity of Beck´s cognitive diathesis-stress model of depression, the present study investigated longitudinal effects of dysfunctional attitudes and stressful life events on the development of depressive, eating disorder and aggressive symptoms in children and adolescents. A large sample of initially asymptomatic children and adolescents completed self-report symptom measures at study entrance and again approx. 20 months later, and reported stressful life events during the study interval. Stressful life events proved to be a risk factor to all investigated symptom domains. Dysfunctional attitudes at T1 were prospectively related to depressive symptoms, aggressive behavior and weight concerns at T2. However, types of associations varied as dysfunctional attitudes showed linear associations with weight concern, but nonlinear effects on depressive and aggressive symptomatology. Findings of the current study thus suggest that dysfunctional attitudes are not uniquely related to the development of depressive symptomatology in children and adolescents, but may contribute to adverse outcomes in various symptom domains. Thus, intervention efforts based on Beck´s vulnerability - stress model of depression may turn out to be useful in reducing vulnerability to a variety of outcomes in children and adolescents.
Sep 2016 DOI 10.14302/issn.2574-450X.jom-16-1062
Gudala MeghanaCorresponding author
Division of Pediatric Endocrinology, Baystate Children’s Hospital, 50 Wason Avenue, Springfield, Massachusetts 01199
Background: Obese adults with Type 2 Diabetes (T2D) have shown differences in body composition and response to varying diets when compared to obese adults without T2D. This difference in body composition affects management options for obesity. Such studies have not been done on adolescents thus far. Objectives: To estimate differences in fat mass at baseline as well as following a two-week high protein liquid diet in obese adolescents with and without T2D. Methods: Thiswas a pilot study using a non-randomized, unblinded pre/post intervention design without a control group. We planned to recruit 40 subjects (20 per group, with and without T2D) from ages 10 – 19 years, with Body mass index (BMI) ≥ 95 percentile. Body fat mass was measured via the Bod Pod® at baseline and after two weeks of following the diet with Ensure High Protein shakes. Change in fat mass is presented as mean differences and 95% confidence intervals. Results: We recruited 28 subjects, 19 completed the study and 12 were compliant with the diet. The mean difference in fat mass percent from baseline in subjects who completed the study (n=19) and without T2D was 1.4 (95% confidence interval (CI): -2.1 to -0.8) and in subjects with T2D was 1.2 (95% CI: -3.6 to 1.24). Conclusion: We did not find any meaningful difference in fat mass at baseline or after following a two-week high protein diet between the groups. High dropout rate and noncompliance with the diet were major limitations.
Aug 2016 DOI 10.14302/issn.2474-3585.jpmc-16-1115
Tatemichi MasayukiCorresponding author
Department of Preventive Medicine, Tokai University, School of Medicine, Kanagawa, Japan
Purpose: To determine an appropriate time interval for conducting mass screening for glaucoma, it is important to gather information on the annual incidence rate. Thus, a retrospective cohort study was conducted to determine the annual incidence rate of visual field abnormalities (VFA) among a workplace cohort. Methods: In an initial visual field test using frequency doubling technology (FDT) perimetry conducted on 3443 employees (mean age 47.4 ± 8.9, men/women = 2967/476), no abnormalities were observed. Subjects were followed-up with annual perimetric testing for seven years, with VFA being determined using FDT test (FDT-VFA). Results: Using theKaplan–Meier method (log rank test, p < 0.001), cumulative FDT-VFA rates (SE) at seven years for subjects in their 30s, 40s, 50s, and 60s or older were found to be 3.0% (0.6), 4.2 % (0.6), 4.8 (0.8), and 11.3% (0.2), respectively. A linear fit to the Kaplan–Meier results yielded an annual incidence rate of 0.42%, 0.60%, 0.77%, and 1.60% for the 30s, 40s, 50s, and ≥60s age groups, respectively. Conclusion: Our data suggest that the annual incidence rate of VFA is <0.7% per year in subjects younger than 60 years of age; however, it increases to 1.6% per year in older subjects, thus suggesting that the monitoring frequency of glaucoma patients may need to be adjusted as a function of their age and be performed more frequently after the age of 60 years
Aug 2016 DOI 10.14302/issn.2470-5020.jnrt-16-1200
Alhashemi HashemCorresponding author
Physical Medicine & Rehabilitation consultant, Department of Medicine, KAMC Jeddah, Assistant Professor at KSAU-HS
Objective: To assess mortality, medical complications, and care indicators among stroke patients admitted to general medical units at King Abdulaziz Medical City-Jeddah-Saudi Arabia. Methods: This retrospective cohort study included all adult patients (>16 years) admitted to KAMC-Jeddah between January 1, 2014, and June 30, 2015, with acute stroke. Data regarding in-hospital stroke mortality and medical complications (pressure ulcer, pneumonia, venous thromboembolism dysphagia, and wheelchair dependency) and stroke care indicators (time-to-CT, carotid imaging, lipid profile, physical therapy, swallowing assessment, nutritional assessment, and length of stay) were collected. Results: Patients included were 208. Acute stroke mortality was 19%, while wheelchair dependency, and dysphagia on discharge were 39% and 56% respectively in general medical units. The incidence of pressure ulcers, pneumonia, and venous thromboembolism was 17%, 14%, and 3%, respectively. Pneumonia (odds ratio OR, 5.5; P = 0.002; 95% confidence interval CI, 1.9–16), abnormal troponin level (OR, 4.4; P = 0.002; 95% CI, 1.7–11),hemorrhagic stroke (OR, 3.9; P = 0.015; 95% CI, 1.3–12), and pressure ulcers (OR, 3.0; P = 0.036; 95% CI, 1.1–8.0) were significantly associated with increased mortality. Median time to CT scan was 117 minutes. Carotid imaging was performed for 67% of ischemic stroke patients, and 65% underwent fasting lipid profile assessment. Assessment by nutritionist, physiotherapist, and swallowing therapist was done for 90%, 76%, and 53% of stroke patients respectively. The median length of stay was 12 days. Conclusion: Acute stroke mortality was 19 %, while wheelchair dependency, and dysphagia on discharge were 39% and 56% respectively in general medical units at KAMC Jeddah. Pneumonia, abnormal troponin, hemorrhagic stroke, and pressure ulcers are associated with increased mortality. Future research is needed to compare outcomes of stroke care between general units and specialized stroke units nationally.
Jun 2016 DOI 10.14302/issn.2577-137X.ji-16-1026
N. Babirye JulietCorresponding author
School of Public Health, Makerere University College of Health Sciences.
Millions of children continue to miss immunizations each year despite global increases in financing and advances in vaccine technology. Male involvement in routine child immunization activities could improve and sustain coverage but is rarely emphasized in immunization programs or research. This study identified factors associated with male involvement in routine child immunization using the attitude, social influence and self-efficacy model.A household cluster survey was conducted among 460 fathers aged 18 years or more, with children aged 10-23 months. A semi-structured interviewer-administered questionnaire was used to collect data. Prevalence Risk Ratios (PRRs) were used to measure associations with level of involvement using generalized linear models with Poisson family, log link and robust standard errors in STATA 12. Our findings show that half (51%, 236/460) of the respondents were aged 25-34 years; 36% (166/460) had completed eight or more years of formal education. Although90% (415/460) of the respondents were willing to be involved, only 29% (133/460) were highly involved in routine child immunization. Highly involved fathers had a positive attitude towards involvement in routine child immunization (adj. PRR 2.3, 95% CI 1.18 – 4.98) and were ≥45 years adjusted prevalence risk ratio (adj. PRR) 2.0, 95% confidence interval (CI) 1.15 - 3.76. Traders had a lower involvement compared to those engaged in other occupations (adj. PRR 0.55, 95% CI: 0.37 - 0.82). In conclusion, few fathers were involved in routine child immunization. Strategies to improve fathers’ positive attitude such as health education are needed to increase their involvement, specifically targeting younger fathers and traders.
Mar 2016 DOI 10.14302/issn.2474-3585.jpmc-15-757
Hong LiuCorresponding author
Xijing Hospital of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032,Shaanxi Province, China
Objective: MicroRNAs are involved in the onset, progression and dissemination of esophageal cancer, and they may be useful as prognostic biomarkers. This study aims to evaluate the relation of miR-21 expression and the prognosis of esophageal cancer patients. Methods: In this study, a meta-analysis is performed by searching PubMed, Science Direct databases, and Cochrane Library. Data are extracted from studies evaluating survival of esophageal cancer patients with either high or low miR-21 expression. Pooled hazard ratios (HRs) and 95% confidence intervals (CI) are calculated. Results: A total of 579 cases of esophageal cancer from five studies are involved for this global meta-analysis. The HR of survival of patients with high miR-21 expression is 1.47 (95% CI: 1.12–1.91; p<0.01) as compared with those with low expression. Conclusions: miR-21 may be a predictor for survival of esophageal cancer patients.
Jun 2015 DOI 10.14302/issn.2374-9431.jbd-12-164
Lima-Gomez VirgilioCorresponding author
Hospital Juarez de Mexico, Av. IPN 5160 Colonia Magdalena de las Salinas, CP 06770, México City, México.
Objective: To identify the efficacy of focal photocoagulation to maintain or achieve best corrected visual acuity (BCVA) ≥20/40 in eyes with clinically significant macular edema (CSME) that had a focal angiographic pattern. Material and Methods: Non-experimental, retrospective, longitudinal, descriptive study in type 2 diabetic patients of any gender, who had CSME with focal angiographic pattern, who received focal photocoagulation from January to October 2012, with a register of BCVA before and 3 weeks after photocoagulation. 101 eyes from patients aged 35-74 years (mean 60.1±8.15) were assigned to one of two groups: 1, with BCVA before treatment <20/40 (n=60), and 2, with BCVA ≥20/40 (n=41). The proportion of eyes with BCVA≥20/40 after treatment was identified, in the sample and within each group. Results: In group 1 BCVA improved in 34 eyes (56.7%), did not change in 15 (25%), and worsened in 11 (18.3%); in group 2 BCVA improved in 10 eyes (24.4%), did not change in 18 (43.9%) and worsened in 13 (31.7%). Post treatment BCVA was ≥20/40 in 57 eyes (56.4%, 95% confidence intervals 46.8-66.1%), 21 of them from group 1 (36.8%) and 36 from group 2 (63.2%). Conclusion: Treating CSME with focal photocoagulation was efficacious to maintain BCVA ≥20/40 in 87.8% of eyes with that rank of vision preoperatively, and to achieve BCVA ≥20/40 in 35% of eyes without it. Early detection and treatment of CSME is required to increase the proportion of eyes with BVCA that provides visual independence, preferably when visual function is still good.
Jun 2015 DOI 10.14302/issn.2379-7835.ijn-14-608
M. Oddo VanessaCorresponding author
Department of International Health, Johns Hopkins Bloomberg School of Public Health
This study sought to assess the impact of part-time employment on the nutritional status of women in rural Nepal. We used longitudinal data from a prospective cohort of women in the Sarlahi District of southeastern Nepal to assess whether part-time employment was associated with a change in mid-upper-arm circumference (MUAC) between baseline and five-years. The women enrolled in the study (n =715) had applied for part-time employment distributing weekly vitamin A supplements to married women of childbearing age. Over the five-years of follow-up, women received 900 Nepalese rupees ($15 USD) per month, for approximately five hours of work per week. The women who were hired (n =324) were younger and better educated than those who were not hired (n =391), but were otherwise similar. After baseline adjustments, change in MUAC (in cm) (β = 0.08; 95 % CI: -0.20, 0.36) was not associated with employment. Also, changes in MUAC over time were inversely related to baseline MUAC, with better nourished women gaining less (MUAC of 23 - 24.99: β = -0.83; 95% Confidence Interval CI: -1.18, -0.48; MUAC of ≥ 25: β = -0.99; 95% CI: -0.99, -0.54) compared to thin women (MUAC <21). In this sample, women employed part-time did not have improved nutritional status as compared to their unemployed counterparts. Future research should explore the impact of women’s employment on the nutritional status of other members of the household, particularly children, and among women employed full-time.
Jun 2015 DOI 10.14302/issn.2474-3585.jpmc-14-540
Diederichsen ACPCorresponding author
Department of Cardiology, Odense University Hospital (OUH), Denmark.
Objective Measuring coronary artery calcification (CAC) enables to optimize cardiovascular risk-stratification also in patients with type 2 diabetes mellitus (T2D), however the prevalence of CAC in randomly selected patients with T2D is uncertain. For this purpose we set out to examine and compare the occurrence of CAC in unselected T2D patients. Design A randomly selected cohort of 1825 individuals, men and women, either 50 or 60 years old, were invited to the screening study. Traditional risk factors were obtained and a non-contrast CT-scan was performed to assess the CAC score. Results A total of 1211 individuals participated, of whom 54 (4%) had T2D while 1157 (96%) were without diabetes. CAC was present in 62% of the patients with T2D versus 44% in those without (p=0.013). Also the prevalence of traditionally risk factors was high in patients with T2D as compared to subjects without T2D. When adjusting for age, gender, smoking, hypertension and hypercholesterolemia in multivariate logistic regression, T2D was not associated with presence of CAC (OR=1.0; 95% confidence interval 0.5 - 2.0, p=0.94). Conclusions One-third of patients with T2D did not have any CAC, and T2D per se was not associated to CAC.
Aug 2014 DOI 10.14302/issn.2473-1005.jdoi-14-413
A. Ibrahim DinaCorresponding author
Demonstrator in Dental Biomaterials, Faculty of Dentistry, Mansoura UniverAsity, Mansoura, Egypt.
Objectives: This study was conducted to evaluate the effect of sport and energy drinks on conventional and resin-modified glass ionomer restorative materials regarding fracture toughness, surface roughness and fluoride release. Methods: The restorative materials used were conventional and resin-modified glass ionomers. Sport drinks used were Gatorade Perform 02 and Pocari sweat, while the energy drinks were Red Bull and Power Horse. Specimens were prepared and divided into five groups according to the immersion media (distilled water, two sport drinks and two energy drinks) for 1 and 7 days. The fracture toughness was determined using three-point bending method. Surface roughness was measured using surface profilometer. Fluoride release was determined using a conventional ion chromatograph testing unit. The data were analyzed using three-way ANOVA and Least Significant Difference test. For comparison between the two materials under each condition, t-test was used. Results: There was no significant difference in fracture toughness between sport, energy drinks and distilled water at the different time intervals except for conventional glass ionomer after 7 days. Resin-modified glass-ionomer exhibited smoother surfaces more than conventional one in sport and energy drinks after 1 day. After 7 days, both conventional and resin-modified glass ionomers showed greater surface roughness. Both conventional and resin-modified glass ionomers release more fluoride in acidic beverages than distilled water. Conclusions: The effect of sport and energy drinks on the fracture toughness may depend on the composition and acidity of drink. Fluoride release increased with the consumption of sport and energy drinks.
Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-12-157
Aryal NirmalCorresponding author
Division of Applied Health Sciences, Forester Hill Campus, University of Aberdeen, Aberdeen, Scotland, UK
Background: Human Immunodeficiency Virus (HIV) and antiretroviral therapy (ART) are found to be strongly associated with cardiovascular diseases. Data are sparse on the prevalence and distribution of cardiovascular risk factors among people being treated for HIV in South Asia region. Methods: A cross-sectional study of 103 HIV patients (51 women and 52 men) attending routine follow-up consultations at the largest ART centre in Nepal was conducted. Data on several cardiovascular risk factors were collected through interview questionnaires, biophysical measurements and consulting medical records. Results: The most common cardiovascular risk factors observed were central obesity 34.6% 95% Confidence Interval (CI): 25.3% to 43.9%, chronic kidney disease {20.7% (95% CI: 11.6% to 29.7%)} and tachycardia {20.6% (95% CI: 12.7% to 28.5%)}. Females were significantly more likely to have central obesity (male 9.8% vs. female 60%, p=0.016) and chronic kidney disease (male 15.4% vs. female 26.3%, p=0.003) as compared to the males. Participants were fairly active but a large proportion, especially men, had smoked {65% (95% CI: 57%-72.3%)}, used tobacco products {66% (95% CI: 56.4%-74.4%)} or drugs (53.8% of the men) and consumed alcohol {60.2% (95% CI: 50.5%-69.1%)}. Conclusion: A high prevalence of several cardiovascular risk factors was observed among patients being treated for HIV in Nepal. Further larger studies are warranted to better understand the relevance and public health impact of cardiovascular risk factors in this region.